RA 9048 Form No. 1.
1 (LCRO)
Republic of the Philippines
Local Civil Registry Office
Province: Cebu
City of Toledo
Republic of the Philippines ) Petition No.: ________________
City of Toledo ) SS
PETITION FOR CORRECTION OF CLERICAL ERROR IN THE
CERTIFICATE OF LIVE BIRTH
I, LEOFIL CABAHUG COSTANILLA, of legal age, Filipino, and a resident of
Magdugo, Toledo City after having been sworn to in accordance with law, hereby declare that:
1) I am the petitioner seeking the correction of entry in:
a) The certificate of live birth of LEOFIL CABAHUG COSTANILLA.
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2) I was born on May 1, 1986 in Iligan City, Lanao del Norte.
3) The birth was recorded under registry number 86-5844.
4) The clerical error(s) to be corrected is/are (use additional sheets, if necessary)
ITEM NO. DESCRIPTION FROM TO
2 Sex MALE FEMALE
5) The facts/reasons for filing this petition are the following:
Correction of erroneous entry to reflect the correct sex or gender in my birth
certificate.
6) I submit the following documents to support this petition: (use additional sheets if
necessary)
a) Certificate of Live Birth issued by the Philippine Statistics Authority.
7) I have not filed any similar petition and that to the best of my knowledge, no other
similar petition is pending with any LCRO or Court of the Philippine Consulate.
8) I am filing this petition at the LCRO of Toledo City, Province of Cebu in accordance
with RA 9048 and its implementing rules and regulations.
LEOFIL CABAHUG COSTANILLA
Affiant
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VERIFICATION
I, LEOFIL CABAHUG COSTANILLA, under oath, states:
1. I am the petitioner of the above petition for correction of clerical error of entries of the
birth certificate of myself;
2. I have caused the preparation of this petition;
3. I have read the petition and all the facts stated here are true and correct to the best of my
personal knowledge and based on authentic records.
IN WITNESS WHEREOF, I have affixed my signature this _________ of __________
2022 at Municipality of Balamban, Cebu.
LEOFIL CABAHUG COSTANILLA
Affiant
SUBSCRIBED AND SWORN to before me this _________ of __________ 2022 at
Municipality of Balamban, Cebu, petitioner exhibited to me her National Identification No.
5812-8509-1548-2172 issued at Toledo City, as proof of identity.
Doc No.: ____
Page No.: ____
Book No.: ____
Series of: ______
For C/MCR use only
ACTION TAKEN BY THE C/MCR
Granted Denied (Provide basis for denial)
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Date: ________ ________________________
City/Municipal Civil Registrar
For CRG use only
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ACTION TAKEN BY THE CRG
Affirmed Impugned
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Date: ____________ _______________________
City Registrar General
OR No.: _________________________
Amount Paid: _____________________
Date Paid: ________________________
